This study was conducted to evaluate the effect of ambroxol on preventing the infantile respiratory distress syndrome (IRDS) in preterm birth at the Dept. of Obstetrics and Gynecology of Taegu Catholic Medical Center during the period from Jan. 1996 to Dec. 1996. Total of 68 cases were evaluated including 16 ambroxol group and 52 control group. The result were as follows : 1. In the comparison of preventing IRDS, there was 0 case of IRDS in ambroxol group and 7 cases of IRDS in control group (13.46 %). There was a significant difference between two groups (p<0.05). 2. The side effects of ambroxol after administration were nausea in 5 cases, headache in 3 cases, and chest discomfort in 4 cases, but these were not serious and self controlled. 3. There was no significant difference in neonatal morbidity between two groups (p > 0.05).
Ambroxol* ; Daegu ; Gynecology ; Headache ; Nausea ; Obstetrics ; Premature Birth ; Respiratory Distress Syndrome, Newborn* ; Thorax

Ovarian granulosa cell tumor is a uncommon low-grade feminizing malignancy. Its natural history shows slow growth without pain. It often reveals to be very large sized mass when diagnosed, and is confined to the involved ovary in many cases. Complete surgical removal is primary treatment and recurrences thereafter are relatively common. Postoperative adjuvant therapy including reoperation, chemotherapy, radiation therapy or a combination therapy has been used with various degrees of success. We experienced a case of huge ovarian granulosa cell tumor occupying whole abdominal cavity by rapid growth, which is presented with a brief review of corresponding literatures.
Abdominal Cavity ; Drug Therapy ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Natural History ; Ovary* ; Recurrence ; Reoperation

Cryptococcosis has been considered as an opportunistic mycosis associated with depressed immune function of the host. However, it may develop in healthy individuals without any underlying disease. Recently, we experienced a case of pulmonary cryptococcosis in healthy person. The patient had experienced hemoptysis and dry cough persisted for a month. The chest X-ray and CT showed multifocal pneumonic consolidation containing small cavities in RLL, LUL and LLL. Fiberoptic bronchoscopy didn't revealed endobronchial lesion in both lungs. Transbronchial lung biopsy(TBLB) was done, and we could diagnose pulmonary cryptococcosis by means of histopathologic examination. Clinical evaluations did not reveal immune deficiency or evidence of other specific disease. The patient was treated with fluconazole and resulted in clinical and radiological improvement. Cryptococcosis has well known for its meningeal involvement. Although primary pulmonary cryptococcosis is rare, we must think of it when meet mass or nodular lesion on the chest radiology.
Biopsy* ; Bronchoscopy ; Cough ; Cryptococcosis* ; Fluconazole ; Hemoptysis ; Humans ; Lung* ; Thorax

Hypermesis gravidarum is a complication defined as vomiting severe enough to require hospital admission during early pregnancy. Thiamine deficiency is known to lead to certain neurological seguelae including Wernicke-Korsakoff syndrome. Wernicke's encephalopathy is an illness of acute onset characterized by global confusion, paralysis of eye ball movements, and gate ataxia due to a deficiency of thiamine. The immediate administration of thiamine prevents progression of the disease and reverses brain lesions that have not yet progressed to the point of fixed structural change. We have experienced a case of Wernicke-Korsakoff syndrome associated with hyperemesis gravidarum, which seemed to be developed by prolonged thiamine-free fluid therapy. We emphasize the need for thiamine supplementation in hyperemesis gravidarum patients.
Ataxia ; Brain ; Female ; Fluid Therapy ; Humans ; Hyperemesis Gravidarum* ; Korsakoff Syndrome* ; Paralysis ; Pregnancy ; Thiamine ; Thiamine Deficiency ; Vomiting ; Wernicke Encephalopathy

PURPOSE: Combined chemoradiotherapy is standard management for locally advanced non-small cell lung cancer (LA-NSCLC), but standard treatment for elderly patients with LA-NSCLC has not been confirmed yet. We evaluated the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for elderly patients with LA-NSCLC. MATERIALS AND METHODS: Among patients older than 65 years with LA-NSCLC, 36 patients, who underwent CCRT were retrospectively analyzed. Chemotherapy was administered 3-5 times with 4 weeks interval during radiotherapy. Thoracic radiotherapy was delivered to the primary mass and regional lymph nodes. Total dose of 54-59.4 Gy (median, 59.4 Gy) in daily 1.8 Gy fractions and 5 fractions per week. RESULTS: Regarding the response to treatment, complete response, partial response, and no response were shown in 16.7%, 66.7%, and 13.9%, respectively. The 1- and 2-year overall survival (OS) rates were 58.2% and 31.2%, respectively, and the median survival was 15 months. The 1- and 2-year progression-free survivals (PFS) were 41.2% and 19.5%, respectively, and the median PFS was 10 months. Regarding to the toxicity developed after CCRT, pneumonitis and esophagitis with grade 3 or higher were observed in 13.9% (5 patients) and 11.1% (4 patients), respectively. Treatment-related death was not observed. CONCLUSION: The treatment-related toxicity as esophagitis and pneumonitis were noticeably lower when was compared with the previously reported results, and the survival rate was higher than radiotherapy alone. The results indicate that CCRT is an effective in terms of survival and treatment related toxicity for elderly patients over 65 years old with LA-NSCLC.
Aged ; Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Disease-Free Survival ; Esophagitis ; Humans ; Lymph Nodes ; Pneumonia ; Retrospective Studies ; Survival Rate

BACKGROUND: Elastic recoil contributes to the residual lumen reduction immediately after PTCA. We evaluated the factors to influence on immediate elastic recoil after the successful PTCA. METHODS: 88 patients(96 lesions) were studied by quantitative angiography. Angiograms were obtained in two identical near orthogonal projection before PTCA and immediately after the last balloon deflation. RESULTS: Immediately after PTCA, minimal luminal diameter increased from 0.7+/-0.6mm to 1.9+/-0.6mm and percent diameter stenosis was reduced from 77+/-20 to 34+/-21%. The calculated mean elastic recoil was 0.5+/-0.7mm in diameter and % elastic recoils were lesser both in calcified(3+/-23 vs 23+/-24%, p=0.04) and thrombotic(9+/-20 vs 23+/-35%, p=0.02) lesions. The elastic recoil increased significantly according to the inflation diameter of balloon(r=0.32, p<0.01. No significant correlation between the immediate elastic recoil and age, sex, risk factors, eccentricity and lesion length was shown. CONCLUSION: The elastic recoil immediately after a successful PTCA was dependent on the existance of calcium and thrombus on the target lesion and on the balloon size at the maximal inflation.
Angiography ; Angioplasty, Balloon, Coronary* ; Calcium ; Constriction, Pathologic ; Inflation, Economic ; Phenobarbital ; Risk Factors ; Thrombosis

A 21-year-old woman found to be hypertensive was referred for hypertension. On examination, blood pressure was 170/110mmHg in the right arm, 160/100mmHg in left arm,and 120/70mmHg in legs. A grade 2/6 systolic ejection murmur was present at the left upper sternal border, and a chest x-ray revealed a rib notching on the inferior margin of 4th rib. Two-dimensional echocardiogram showed the coarctation of aorta beyound the origin of the left subclavian artery. Biplane TEE demonstrated a discrete narrowing of the descending aorta at the site of coarctation. The blood pressure was 169/86mmHg in ascending aorta and 118/84mmHg in descending aorta. Aortogram showed a localized coarcted aortic segment of 7mm in diameter and 5mm long just distal to the left subclavian artery. Balloon coarctation angioplasty was performed with 7F 30x15mm pediatric balloon dilatation catheter. Balloon position was confirmed on fluoroscopy by the hourglass appearance of the balloon inflation and thereafter, the balloon was inflated until the waist of the balloon disappeared. After procedure, a pull back pressure tracing across the coarctation of aorta revealed no pressure gradient between ascending and descending aorta with 141/90mmHg. Aortogram showed an increase in diameter of the coarctation of aorta to 18mm with aneurysmal formation. 3 months later, follow up aortogram showed no significant change in diameter of coarctation of aorts or aneurysmal formation. Nonsurgical balloon coarctation angioplasty appears to be an alternative therapy for the coarctation of aorta in adults.
Adult* ; Aneurysm ; Angioplasty* ; Angioplasty, Balloon ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Catheters ; Dilatation ; Female ; Fluoroscopy ; Follow-Up Studies ; Humans ; Hypertension ; Inflation, Economic ; Leg ; Ribs ; Subclavian Artery ; Systolic Murmurs ; Thorax ; Young Adult

OBJECTIVE: Metroplasty has been shown to improve the reproductive outcomes in patients with congenital uterine anomalies, especially for those suffering from multiple fetal losses. This study was performed to evaluate the impact of abdominal metroplasty on the reproductive outcomes in patients with infertility or recurrent abortions. METHODS: Among fifty cases diagnosed as Mullerian anornalies at SNUH from Oct. 1988 to Dec. 1996, only 26 cases were included in this retrospective study. Inclusion criteria was the patients with primary infertility(n=7) or recurrent spontaneous abortions(n 19) who underwent abdominal metroplasty for the correction of uterine anomalies. Statistical analysis was carried out by chi-square test using SPSS ver 7.0. RESULTS: Bicornuate uterus was the most common uterine anomaly as 53.9%(14/26). After metroplaty, the overall live birth rate was increased from 0% to 57.7%(15/26), and the live birth rate in patients with recurrent abortions, 68.4%(13/19), was significantly higher than that in patients with primary infertility, 28.6%(2/7). The rate of fetal wastage was dropped from 96.0%(48/50) to 41.7%(10/24) after metroplasty in 19 patients with recurrent abortions. Pelvic pathologic lesions associated with uterine anomalies were diagnosed in 11(42.3%) patients, and 45.5%(5/11) of them succeeded in live births postoperatively. CONCLUSION: These data showed that metroplasty may improve the reproductive outcomes definitely in patients with recurrent abortions. Although the impact of metroplasty on the fertility in infertile patients was not definite, it seems better to perform metroplasty in infertile patients with uterine anomaly, which offers the opportunity to correct the combined pelvic lesions such as myoma, ovarian cyst or endometriosis, and to avoid the chance of abortion after ART(assisted reproductive technology) such as 1VF-ET.
Abortion, Habitual ; Endometriosis ; Female ; Fertility ; Humans ; Infertility ; Live Birth ; Myoma ; Ovarian Cysts ; Pregnancy ; Retrospective Studies ; Uterus

OBJECTIVE: To determine the reproductive outcomes of women undergoing microsurgical reversal of tubal sterilization at age 36 years or older. MATERIALS AND METHODS: A series of 133 patients who received microsurgical reversal of the previously sterilized fallopian tubes at Seoul National University Hospital from July, 1980 to January, 1992 was reviewed and evaluated for clinical characteristics, pregnancy rates, and factors influencing the outcome of tubal reversal. RESULTS: Of 133 patients, 78 (58.6%) had been sterilized by laparoscopic cautery. Loss of children was a leading cause for tubal reversal. The mean interval from tubal sterilization to tubal reversal was 65.0 months. The overall pregnancy rate was 52.6% (70/133), and the mean interval was 9.4 months from tubal reversal to pregnancy. Excluding 7 patients who were lost to follow-up, 76 pregnancies were confirmed in 63 patients with the delivery rate per patient of 66.7% (42/63). There were no significant differences in age, duration of tubal sterilization, postoperative tubal length between pregnant and non-pregnant groups. CONCLUSIONS: Microsurgical reversal of tubal sterilization could be a justifiable method in women 36 years age or older.
Cautery ; Child ; Fallopian Tubes ; Female ; Humans ; Lost to Follow-Up ; Pregnancy ; Pregnancy Rate ; Seoul ; Sterilization, Tubal*

BACKGROUND: Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. METHODS: The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. RESULTS: Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. CONCLUSIONS: The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room.
Automation, Laboratory ; Efficiency, Organizational/*standards ; Phlebotomy/*statistics & numerical data ; Republic of Korea ; Time Factors ; Workflow